I 

114TH CONGRESS 

1ST SESSION H. R. 4011 

To increase the number of graduate medical education positions treating 

veterans, to improve the compensation of health care providers, medical 

directors, and directors of Veterans Integrated Service Networks of the 

Department of Veterans Affairs, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

NOVEMBER 16, 2015 

Mr. GALLEGO (for himself, Mrs. KIRKPATRICK, Ms. PINGREE, Mr. HONDA, 

and Ms. ESTY) introduced the following bill; which was referred to the 

Committee on Veterans’ Affairs, and in addition to the Committees on 

Ways and Means and Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such 

provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To increase the number of graduate medical education positions treating veterans, to improve the compensation of 

health care providers, medical directors, and directors 

of Veterans Integrated Service Networks of the Department of Veterans Affairs, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

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1 erans Act of 2015’’ or the ‘‘DOCs for Veterans Act of 

2 2015’’. 

3 (b) TABLE OF CONTENTS.—The table of contents for 

4 this Act is as follows: 

Sec. 1. Short title; table of contents. 

TITLE I—MEDICAL EDUCATION AND TRAINING 

Sec. 101. Disregard of resident slots that include VA training against the Medicare graduate medical education limitations. 

Sec. 102. Extension of period for increase in graduate medical education residency positions at medical facilities of the Department of Veterans Affairs. 

Sec. 103. Pilot program on graduate medical education residency programs in 

behavioral medicine in underserved areas. 

Sec. 104. Inclusion of mental health professionals in education and training 

program for health personnel of the Department of Veterans 

Affairs. 

Sec. 105. Expansion of qualifications for licensed mental health counselors of 

the Department of Veterans Affairs to include doctoral degrees. 

TITLE II—HEALTH CARE PROVIDERS OF THE DEPARTMENT OF 

VETERANS AFFAIRS 

Sec. 201. Requirement that physician assistants employed by the Department 

of Veterans Affairs receive competitive pay. 

Sec. 202. Modification of education debt reduction program of Department of 

Veterans Affairs to require a certain amount to be spent in 

rural and highly rural areas. 

Sec. 203. Report on medical workforce of the Department of Veterans Affairs. 

TITLE III—LEADERSHIP OF THE VETERANS HEALTH 

ADMINISTRATION 

Sec. 301. Establishment of positions of Directors of Veterans Integrated Service Networks in Office of Under Secretary for Health of Department of Veterans Affairs and modification of qualifications 

for Medical Directors. 

Sec. 302. Pay for Medical Directors and Directors of Veterans Integrated Service Networks. 

TITLE IV—OTHER HEALTH CARE MATTERS 

Sec. 401. Pilot program on providing nurse advice line for veterans in rural and 

highly rural areas. 


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1 TITLE I—MEDICAL EDUCATION 

2 AND TRAINING 

3 SEC. 101. DISREGARD OF RESIDENT SLOTS THAT INCLUDE 

4 VA TRAINING AGAINST THE MEDICARE GRAD5 UATE MEDICAL EDUCATION LIMITATIONS. 

6 (a) DIRECT GME.—Section 1886(h)(4)(F) of the So7 cial Security Act (42 U.S.C. 1395ww(h)(4)(F)) is amend8 ed by adding at the end the following new clause: 

9 ‘‘(iii) DISREGARD OF CERTAIN RESI10 DENT SLOTS THAT INCLUDE VA TRAIN11 ING.—For portions of cost reporting peri12 ods beginning on or after July 1, 2017, in 

13 applying the limitations under clause (i) 

14 regarding the total number of full-time 

15 equivalent residents in the field of 

16 allopathic or osteopathic medicine in a hos17 pital’s approved medical residency training 

18 program, the Secretary shall not take into 

19 account any full-time equivalent resident 

20 within such program that is filling a grad21 uate medical education residency position 

22 that counts towards meeting the obligation 

23 of the Secretary of Veterans Affairs au24 thorized under section 301(b)(2)(A) of the 

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1 ability Act of 2014 (Public Law 113–146; 

2 38 U.S.C. 7302 note).’’. 

3 (b) INDIRECT GME.—Section 1886(d)(5)(B)(v) of 

4 the Social Security Act (42 U.S.C. 1395ww(d)(5)(B)(v)) 

5 is amended, in the second sentence, by striking ‘‘sub6 section (h)(4)(F)(ii)’’ and inserting ‘‘clauses (ii) and (iii) 

7 of subsection (h)(4)(F)’’. 

8 SEC. 102. EXTENSION OF PERIOD FOR INCREASE IN GRAD9 UATE MEDICAL EDUCATION RESIDENCY PO10 SITIONS AT MEDICAL FACILITIES OF THE DE11 PARTMENT OF VETERANS AFFAIRS. 

12 (a) IN GENERAL.—Paragraph (2) of subsection (b) 

13 of section 301 of the Veterans Access, Choice, and Ac14 countability Act of 2014 (Public Law 113–146; 38 U.S.C. 

15 7302 note) is amended— 

16 (1) in the paragraph heading, by striking 

17 ‘‘FIVE-YEAR’’ and inserting ‘‘TEN-YEAR’’; and 

18 (2) in subparagraph (A), by striking ‘‘5-year 

19 period’’ and inserting ‘‘10-year period’’. 

20 (b) REPORT.—Paragraph (3)(A) of such subsection 

21 is amended by striking ‘‘until 2019’’ and inserting ‘‘until 

22 2024’’. 


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1 SEC. 103. PILOT PROGRAM ON GRADUATE MEDICAL EDU2 CATION RESIDENCY PROGRAMS IN BEHAV3 IORAL MEDICINE IN UNDERSERVED AREAS. 

4 (a) PILOT PROGRAM.—Commencing not later than 

5 one year after the date of the enactment of this Act, the 

6 Secretary of Veterans Affairs and the Secretary of Health 

7 and Human Services shall jointly conduct a six-year pilot 

8 program to establish not less than three graduate medical 

9 education residency programs in behavioral medicine in 

10 underserved areas in the United States. 

11 (b) ELEMENTS.—Each graduate medical education 

12 residency program established under the pilot program 

13 shall— 

14 (1) provide residents participating in the grad15 uate medical education residency program with an 

16 opportunity to work with a diverse patient popu17 lation through a rotation between medical facilities 

18 of the Department of Veterans Affairs, facilities of 

19 the Indian Health Service, and facilities partici20 pating under the Medicare program under title 

21 XVIII of the Social Security Act (42 U.S.C. 1395 et 

22 seq.); 

23 (2) include graduate medical education in the 

24 field of behavioral medicine; 

25 (3) be carried out in a manner consistent with 

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1 ported and funded by the Department of Veterans 

2 Affairs and the Department of Health and Human 

3 Services; 

4 (4) be located in a community that— 

5 (A) is designated as a medically under6 served area under section 330(b)(3)(A) of the 

7 Public Health Service Act (42 U.S.C. 

8 254b(b)(3)(A)); 

9 (B) is in a State with a per capita popu10 lation of veterans of more than 9 percent ac11 cording to the National Center for Veterans 

12 Analysis and Statistics and the United States 

13 Census Bureau; and 

14 (C) is within 100 miles of a Reservation 

15 (as defined in Section 3(d) of the Indian Fi16 nancing Act of 1974 (25 U.S.C. 1452)). 

17 (c) REPORT.— 

18 (1) IN GENERAL.—Not later than 180 days 

19 after the date of the commencement of the pilot pro20 gram and not less frequently than once each year 

21 thereafter while the pilot program is being carried 

22 out, the Secretary of Veterans Affairs and the Sec23 retary of Health and Human Services shall, in con24 sultation with representatives from facilities partici25 pating under the Medicare program under title 


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1 XVIII of the Social Security Act (42 U.S.C. 1395 et 

2 seq.) that are participating in the pilot program, 

3 jointly submit to Congress a report on the imple4 mentation of the pilot program. 

5 (2) ELEMENTS.—Each report required by para6 graph (1) shall include the following: 

7 (A) A description of the patient population 

8 served by the residents participating in a grad9 uate medical education residency program 

10 under the pilot program. 

11 (B) A description of the behavioral medi12 cine services provided under the pilot program, 

13 including the extent to which those services 

14 were provided using telemedicine services. 

15 (C) The academic affiliation of each resi16 dent participating in a graduate medical edu17 cation residency program under the pilot pro18 gram. 

19 (D) A description of any impediments 

20 faced in carrying out the pilot program and ac21 tions taken by the Secretary of Veterans Affairs 

22 and the Secretary of Health and Human Serv23 ices to address those impediments. 


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1 SEC. 104. INCLUSION OF MENTAL HEALTH PROFESSIONALS 

2 IN EDUCATION AND TRAINING PROGRAM FOR 

3 HEALTH PERSONNEL OF THE DEPARTMENT 

4 OF VETERANS AFFAIRS. 

5 (a) IN GENERAL.—In carrying out the education and 

6 training program required under section 7302(a)(1) of 

7 title 38, United States Code, the Secretary of Veterans 

8 Affairs shall include education and training of marriage 

9 and family therapists and licensed professional mental 

10 health counselors. 

11 (b) APPORTIONMENT OF FUNDING.—The Secretary 

12 shall apportion funding for the education and training 

13 program described in subsection (a) equally among the 

14 professions included in the program. 

15 SEC. 105. EXPANSION OF QUALIFICATIONS FOR LICENSED 

16 MENTAL HEALTH COUNSELORS OF THE DE17 PARTMENT OF VETERANS AFFAIRS TO IN18 CLUDE DOCTORAL DEGREES. 

19 Section 7402(b)(11)(A) of title 38, United States 

20 Code, is amended by inserting ‘‘or doctoral degree’’ after 

21 ‘‘master’s degree’’. 


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1 TITLE II—HEALTH CARE PRO2 VIDERS OF THE DEPART3 MENT OF VETERANS AFFAIRS 

4 SEC. 201. REQUIREMENT THAT PHYSICIAN ASSISTANTS EM5 PLOYED BY THE DEPARTMENT OF VETERANS 

6 AFFAIRS RECEIVE COMPETITIVE PAY. 

7 Section 7451(a)(2) of title 38, United States Code, 

8 is amended— 

9 (1) by redesignating subparagraph (B) as sub10 paragraph (C); 

11 (2) by inserting after subparagraph (A) the fol12 lowing new subparagraph (B): 

13 ‘‘(B) Physician assistant.’’; and 

14 (3) in subparagraph (C), as redesignated by 

15 paragraph (1), by striking ‘‘and registered nurse’’ 

16 and inserting ‘‘registered nurse, and physician as17 sistant’’. 

18 SEC. 202. MODIFICATION OF EDUCATION DEBT REDUCTION 

19 PROGRAM OF DEPARTMENT OF VETERANS 

20 AFFAIRS TO REQUIRE A CERTAIN AMOUNT 

21 TO BE SPENT IN RURAL AND HIGHLY RURAL 

22 AREAS. 

23 Section 7681 of title 38, United States Code, is 

24 amended by adding at the end the following new sub25 sections: 


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1 ‘‘(c) LIMITATION ON AMOUNTS.—Not less than 30 

2 percent of the amount of debt reduction payments paid 

3 under the Education Debt Reduction Program each year 

4 shall be paid to individuals who practice medicine in a 

5 rural area or highly rural area or demonstrate a commit6 ment to practice medicine in such an area. 

7 ‘‘(d) DEFINITIONS.—In this section: 

8 ‘‘(1) The term ‘highly rural area’ means an 

9 area located in a county or similar community that 

10 has less than seven individuals residing in that coun11 ty or community per square mile. 

12 ‘‘(2) The term ‘rural area’ means an area that 

13 is not an urbanized area or a highly rural area. 

14 ‘‘(3) The term ‘urbanized area’ has the mean15 ing given that term by the Director of the Bureau 

16 of the Census.’’. 

17 SEC. 203. REPORT ON MEDICAL WORKFORCE OF THE DE18 PARTMENT OF VETERANS AFFAIRS. 

19 (a) IN GENERAL.—Not later than 120 days after the 

20 date of the enactment of this Act, the Secretary of Vet21 erans Affairs shall submit to the Committee on Veterans 

22 Affairs of the Senate and the Committee on Veterans Af23 fairs of the House of Representatives a report on the med24 ical workforce of the Department of Veterans Affairs. 


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1 (b) ELEMENTS.—The report required by subsection 

2 (a) shall include the following: 

3 (1) With respect to licensed professional mental 

4 health counselors and marriage and family thera5 pists of the Department— 

6 (A) how many such counselors and thera7 pists are currently enrolled in the mental health 

8 professionals trainee program of the Depart9 ment; 

10 (B) how many such counselors and thera11 pists are expected to enroll in the mental health 

12 professionals trainee program of the Depart13 ment during the 180-day period beginning on 

14 the date of the submittal of the report; 

15 (C) a description of the eligibility criteria 

16 for such counselors and therapists as compared 

17 to other behavioral health professions in the 

18 Department; 

19 (D) a description of the objectives, goals, 

20 and timing of the Department with respect to 

21 increasing the representation of such counselors 

22 and therapists in the behavioral health work23 force of the Department; and 

24 (E) a description of the actions taken by 

25 the Secretary, in consultation with the Director 


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1 of the Office of Personnel Management, to cre2 ate an occupational series for such counselors 

3 and therapists and a timeline for the creation 

4 of such an occupational series. 

5 (2) A breakdown of spending by the Depart6 ment in connection with the education debt reduc7 tion program of the Department under subchapter 

8 VII of chapter 76 of title 38, United States Code, 

9 including— 

10 (A) the amount spent by the Department 

11 in debt reduction payments during the three12 year period preceding the submittal of the re13 port disaggregated by the medical profession of 

14 the individual receiving the payments; 

15 (B) a description of how the Department 

16 prioritizes such spending by medical profession, 

17 including an assessment of whether such pri18 ority reflects the five occupations identified in 

19 the most recent determination by the Inspector 

20 General of the Department of Veterans Affairs 

21 as having the largest staffing shortages in the 

22 Veterans Health Administration; and 

23 (C) a description of the actions taken by 

24 the Secretary to increase the effectiveness of 

25 such spending for purposes of recruitment of 


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1 health care providers to the Department, in2 cluding efforts to more consistently include eli3 gibility for the education debt reduction pro4 gram in vacancy announcements of positions for 

5 health care providers at the Department. 

6 (3) A description of any impediments to the de7 livery by the Department of telemedicine services to 

8 veterans and any actions taken by the Department 

9 to address such impediments, including with respect 

10 to— 

11 (A) restrictions under Federal or State 

12 laws; 

13 (B) licensing or credentialing issues for 

14 health care providers, including non-Depart15 ment health care providers, practicing telemedi16 cine with a veteran located in a different State; 

17 (C) the effect of limited broadband access 

18 or limited information technology capabilities on 

19 the delivery of health care; 

20 (D) the distance a veteran is required to 

21 travel to access a facility or clinic with telemedi22 cine capabilities; 

23 (E) the effect on the provision of telemedi24 cine services to veterans of policies of and lim25 ited liability protection for certain entities; and 


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1 (F) issues relating to reimbursement and 

2 travel limitations for veterans that affect the 

3 participation of non-Department health care 

4 providers in the telemedicine program. 

5 (4) An update on the efforts of the Secretary 

6 to offer training opportunities in telemedicine to 

7 medical residents in medical facilities of the Depart8 ment that use telemedicine, consistent with medical 

9 residency program requirements established by the 

10 Accreditation Council for Graduate Medical Edu11 cation, as required in section 108(b) of the Honoring 

12 America’s Veterans and Caring for Camp Lejeune 

13 Families Act of 2012 (Public Law 112–154; 38 

14 U.S.C. 7406 note). 

15 (5) An assessment of the development and im16 plementation by the Secretary of succession planning 

17 policies to address the prevalence of vacancies in po18 sitions in the Veterans Health Administration of 

19 more than 180 days, including the development of 

20 an enterprise position management system to more 

21 effectively identify, track, and resolve such vacan22 cies. 

23 (6) A description of the actions taken by the 

24 Secretary, in consultation with the Director of the 

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1 pediments to the timely appointment and determina2 tion of qualifications for Directors of Veterans Inte3 grated Service Networks and Medical Directors of 

4 the Department. 

5 TITLE III—LEADERSHIP OF THE 

6 VETERANS HEALTH ADMINIS7 TRATION 

8 SEC. 301. ESTABLISHMENT OF POSITIONS OF DIRECTORS 

9 OF VETERANS INTEGRATED SERVICE NET10 WORKS IN OFFICE OF UNDER SECRETARY 

11 FOR HEALTH OF DEPARTMENT OF VETERANS 

12 AFFAIRS AND MODIFICATION OF QUALIFICA13 TIONS FOR MEDICAL DIRECTORS. 

14 Section 7306(a)(4) of title 38, United States Code, 

15 is amended— 

16 (1) by inserting ‘‘and Directors of Veterans In17 tegrated Service Networks’’ after ‘‘Such Medical Di18 rectors’’; and 

19 (2) by striking ‘‘, who shall be either a qualified 

20 doctor of medicine or a qualified doctor of dental 

21 surgery or dental medicine’’. 


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1 SEC. 302. PAY FOR MEDICAL DIRECTORS AND DIRECTORS 

2 OF VETERANS INTEGRATED SERVICE NET3 WORKS. 

4 (a) IN GENERAL.—Chapter 74 of title 38, United 

5 States Code, is amended by adding at the end the fol6 lowing new subchapter: 

7 ‘‘Subchapter VII—Pay for Medical Directors 

8 and Directors of Veterans Integrated 

9 Service Networks 

10 ‘‘§ 7481. Pay for Medical Directors and Directors of 

11 Veterans Integrated Service Networks 

12 ‘‘(a) ELEMENTS OF PAY.—Pay for a Medical Direc13 tor or Director of a Veterans Integrated Service Network 

14 appointed under section 7306(a)(4) of this title (in this 

15 section referred to as a ‘Director’) shall consist of basic 

16 pay set forth under section 7404(a) of this title and mar17 ket pay determined under subsection (b). 

18 ‘‘(b) MARKET PAY.—(1) Each Director is eligible for 

19 market pay determined under this subsection. 

20 ‘‘(2) The amount of market pay payable to a Director 

21 under this section shall be determined by the Secretary 

22 on a case-by-case basis and shall consist of pay intended 

23 to reflect needs of the Department with respect to the re24 cruitment and retention (as determined by the Secretary) 

25 of such Director. 


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1 ‘‘(3) In determining the amount of market pay pay2 able to a Director under this section, the Secretary shall— 

3 ‘‘(A) consult not less than two national surveys 

4 on pay for hospital directors, medical facility direc5 tors, or other similar positions, whether prepared by 

6 private, public, or quasi-public entities, to make a 

7 general assessment of the range of potential pay for 

8 the Director; and 

9 ‘‘(B) take into account— 

10 ‘‘(i) the experience of the Director in man11 aging facilities or program offices of the De12 partment, including the complexity of such fa13 cilities or offices; 

14 ‘‘(ii) the complexity of the facility or facili15 ties to be managed by the Director; 

16 ‘‘(iii) the labor market, in such geographic 

17 area as the Secretary considers relevant, for 

18 hospital directors, medical facility directors, and 

19 other similar positions; 

20 ‘‘(iv) the experience of the Director in 

21 managing medical facilities for other Federal 

22 agencies, private entities, or non-profit entities; 

23 and 

24 ‘‘(v) such other considerations as the Sec25 retary considers appropriate. 


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1 ‘‘(4)(A) The Secretary shall evaluate the amount of 

2 market pay payable to a Director under this section not 

3 less frequently than once every two years and may adjust 

4 the market pay payable to such Director as a result of 

5 such evaluation. 

6 ‘‘(B) A Director whose market pay is evaluated under 

7 subparagraph (A) shall receive written notice of the re8 sults of such evaluation. 

9 ‘‘(c) REQUIREMENTS AND LIMITATIONS ON TOTAL

10 PAY.—(1) Not less frequently than once every two years, 

11 the Secretary shall set forth a Department-wide minimum 

12 and maximum amount for total annual pay under sub13 section (a) that may be paid to a Director and shall pub14 lish each such amount in the Federal Register. 

15 ‘‘(2) The minimum and maximum amounts set forth 

16 under paragraph (1) shall take effect not earlier than the 

17 date that is 60 days after the publication of such amounts 

18 under such paragraph. 

19 ‘‘(3) The sum of the basic pay set forth under section 

20 7404(a) of this title and market pay determined under 

21 subsection (b) for a Director for a calendar year— 

22 ‘‘(A) may not be less than the most recent min23 imum amount set forth under paragraph (1) before 

24 the beginning of such calendar year; and 


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1 ‘‘(B) may not be more than the most recent 

2 maximum amount set forth under such paragraph 

3 before the beginning of such calendar year. 

4 ‘‘(4) The total amount of compensation paid to a Di5 rector under this title in any calendar year may not exceed 

6 the amount of annual compensation (excluding expenses) 

7 of the President under section 102 of title 3. 

8 ‘‘(5) The Secretary may not delegate to an officer or 

9 employee of the Department the requirement of the Sec10 retary to set forth a Department-wide minimum and max11 imum amount under paragraph (1). 

12 ‘‘(d) TREATMENT OF PAY.—Pay under this section 

13 shall be considered pay for all purposes, including retire14 ment benefits under chapters 83 and 84 of title 5 and 

15 other benefits. 

16 ‘‘(e) ANCILLARY EFFECTS OF DECREASES IN PAY.— 

17 (1) A decrease in pay of a Director resulting from an ad18 justment in the amount of market pay of the Director 

19 under subsection (b) shall not be treated as an adverse 

20 action. 

21 ‘‘(2) A decrease in the amount of pay of a Director 

22 resulting from an involuntary reassignment in connection 

23 with a disciplinary action taken against the Director is not 

24 subject to appeal or judicial review.’’. 


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1 (b) CLERICAL AMENDMENT.—The table of sections 

2 at the beginning of chapter 74 of such title is amended 

3 by adding at the end the following: 

‘‘SUBCHAPTER VII. PAY FOR MEDICAL DIRECTORS AND DIRECTORS OF

VETERANS INTEGRATED SERVICE NETWORKS

‘‘7481. Pay for Medical Directors and Directors of Veterans Integrated Service 

Networks.’’. 

4 TITLE IV—OTHER HEALTH CARE 

5 MATTERS 

6 SEC. 401. PILOT PROGRAM ON PROVIDING NURSE ADVICE 

7 LINE FOR VETERANS IN RURAL AND HIGHLY 

8 RURAL AREAS. 

9 (a) IN GENERAL.—Commencing not later than one 

10 year after the date of the enactment of this Act, the Sec11 retary of Veterans Affairs shall conduct a two-year pilot 

12 program to assess the feasibility and advisability of imple13 menting in rural areas and highly rural areas with a large 

14 percentage of veterans a nurse advice line to furnish to 

15 veterans medical advice, appointment and cancellation 

16 services, and information on the availability of benefits 

17 from the Department of Veterans Affairs. 

18 (b) NURSE ADVICE LINE.—In carrying out the pilot 

19 program under subsection (a) the Secretary shall establish 

20 a nurse advice line that— 

21 (1) operates free of charge; 

22 (2) is based on, and improves upon, the nurse 

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1 fense for beneficiaries under the TRICARE program 

2 (as defined in section 1072(5) of title 10, United 

3 States Code); 

4 (3) complies with call center requirements set 

5 forth by URAC; 

6 (4) operates in close consultation with the Sec7 retary to— 

8 (A) establish a process through which the 

9 eligibility of a caller for the nurse advice line 

10 can be validated; 

11 (B) allow eligibility and benefit information 

12 in possession of the Department of Veterans 

13 Affairs to be shared with the nurse advice line; 

14 and 

15 (C) allow the nurse advice line to connect 

16 with appropriate technology and personnel of 

17 the Department for purposes of scheduling ap18 pointments for the receipt of health care from 

19 the Department; and 

20 (5) maintains quality controls to ensure that 

21 calls are answered by a customer service representa22 tive within 30 seconds and with an abandonment 

23 rate of less than 5 percent. 


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1 (c) SERVICES PROVIDED.—The nurse advice line es2 tablished under the pilot program shall provide an array 

3 of services to veterans, including the following: 

4 (1) Medical advice from licensed registered 

5 nurses who assess the symptoms of the caller using 

6 a proprietary clinical algorithm that— 

7 (A) has been shown in peer-reviewed med8 ical journals to most closely emulate the clinical 

9 decisionmaking processes of physicians; and 

10 (B) triages the caller to the appropriate 

11 venue at which the caller may receive the health 

12 care that they need. 

13 (2) Information to address basic questions re14 garding the eligibility of the caller for benefits from 

15 the Department of Veterans Affairs and the avail16 ability of those benefits. 

17 (3) Use of an appointment clerk to facilitate the 

18 scheduling, rescheduling, and cancellation of ap19 pointments for health care from the Department. 

20 (d) REPORT.— 

21 (1) IN GENERAL.—Not later than 120 days 

22 after the date of the completion of the pilot pro23 gram, the Secretary of Veterans Affairs shall submit 

24 to Congress a report on the findings of the Secretary 

25 with respect to the pilot program. 


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1 (2) ELEMENTS.—The report required by para2 graph (1) shall include the following: 

3 (A) A description of the veterans who have 

4 benefitted from advice through the nurse advice 

5 line under the pilot program, including the loca6 tions of the veterans served. 

7 (B) A description of any impediments to 

8 the Secretary in carrying out the pilot program. 

9 (C) A description of any impediments en10 countered by individuals in seeking advice or 

11 services through the nurse advice line under the 

12 pilot program. 

13 (D) An assessment of the feasibility and 

14 advisability of expanding the pilot program to 

15 include more veterans. 

16 (e) DEFINITIONS.—In this section: 

17 (1) HIGHLY RURAL AREA.—The term ‘‘highly 

18 rural area’’ means an area located in a county or 

19 similar community that has less than seven individ20 uals residing in that county or community per 

21 square mile. 

22 (2) RURAL AREA.—The term ‘‘rural area’’ 

23 means an area that is not an urbanized area or a 

24 highly rural area. 


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1 (3) URBANIZED AREA.—The term ‘‘urbanized 

2 area’’ has the meaning given that term by the Direc3 tor of the Bureau of the Census. 

Æ 


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